| Geiss Med Arizona Pc | |
|
2592 N Santiago Blvd Orange CA 92867-1862 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Geiss Med Arizona Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2592 N Santiago Blvd, Orange, California |
| Authorized Official Name and Position | Angelica Leyla Soto (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8554347763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geiss Med Arizona Pc 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 | Geiss Med Arizona Pc 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 |
| NPI Number | 1700477627 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 04/30/2024 |
| Medicare PECOS PAC ID | 6103232111 |
|---|---|
| Medicare Enrollment ID | O20211104002828 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700477627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeremy J Bramwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003178666 PECOS PAC ID: 9739321506 Enrollment ID: I20151016000901 |
| Provider Name | Kirby R Farnsworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124464839 PECOS PAC ID: 4385948355 Enrollment ID: I20160829000906 |
| Provider Name | Mandy M Lim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205241866 PECOS PAC ID: 0446556435 Enrollment ID: I20170929002907 |
| Provider Name | Amber N Nassif |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518598671 PECOS PAC ID: 1759719925 Enrollment ID: I20200415000308 |
| Provider Name | Andrea Tuthill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144777434 PECOS PAC ID: 0547543126 Enrollment ID: I20200527002136 |
| Provider Name | Tarah E Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174097299 PECOS PAC ID: 2264771740 Enrollment ID: I20210507002027 |
| Provider Name | John M Geiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20211104002956 |
| Provider Name | Christina Wohlforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770363533 PECOS PAC ID: 6103272711 Enrollment ID: I20231101003663 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240416002272 |
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